1.4.3.1: First Aid and Cardiopulmonary Resuscitation Training for Staff

All staff members involved in providing direct care to children should complete and document training in pediatric first aid and cardiopulmonary resuscitation (CPR). Courses in pediatric first aid and CPR should be taught in person by instructor-led demonstrations and practiced to ensure the technique could be performed in an emergency. Early care and education programs should follow training renewal cycles recommended by the providing organization (eg, American Heart Association [AHA]).

At least one staff member trained in pediatric first aid and CPR should be in attendance at all times when a child whose special care plan indicates an increased risk of cardiac arrest or complications due to cardiac disease is in attendance.¹ Children with special health care needs who have compromised airways may need to be accompanied to child care by nurses who are able to respond to airway problems (eg, the child who has a tracheostomy and needs suctioning).

While the use of automated external defibrillators (AEDs) on children is rare, early care and education programs should consider having an AED on the premises for potential use on both adults and children. Pediatric pads should be used for children younger than 8 years old.² Trainings should be inclusive to children in care, staff and other adults present in early care and education programs.

Records of successful completion of training and renewal cycles in pediatric first aid and pediatric CPR should be maintained in the employee personnel files on site.

RATIONALE

 

The 2018 update to the AHA “Guidelines for CPR and Emergency Cardiovascular Care” section on pediatric basic life support includes recommendations for hands-only CPR chest compressions. These recommendations include chest compression rates of 100 to 120 compressions/min for infants and children.³

Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency.

Documentation of current certification of satisfactory completion of pediatric first aid and demonstration of pediatric CPR skills in the facility assists in implementing and monitoring for proof of compliance.

 

COMMENTS

 

Additional Resources:

First aid and CPR courses from the American Red Cross can be found here: https://www.redcross.org/take-a-class/babysitting/babysitting-child-care-preparation/child-care-licensing.

First aid and CPR courses from the AHA can be found here: https://cpr.heart.org/AHAECC/CPRAndECC/FindACourse/UCM_473162_CPR-First-Aid-Training-Classes-American-Heart-Association.jsp.

The American Academy of Pediatrics pediatric course in first aid can be found here: https://www.pedfactsonline.com.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

1.4.3.2 Topics Covered in Pediatric First Aid Training
1.4.3.3 Cardiopulmonary Resuscitation Training for Swimming and Water Play
9.4.1.2 Maintenance of Records
9.4.3.3 Training Record
10.6.1.1 Regulatory Agency Provision of Caregiver/Teacher and Consumer Training and Support Services
10.6.1.2 Provision of Training to Facilities by Health Agencies

REFERENCES

1. Marino BS, Tabbutt S, MacLaren G, et al; American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Emergency Cardiovascular Care Committee. Cardiopulmonary resuscitation in infants and children with cardiac disease: a scientific statement from the American Heart Association. Circulation. 2018;137(22):e691–e782

2. American Academy of Pediatrics. Using an AED. Healthy Children. https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Using-an-AED.aspx Updated May 09, 2018. Accessed April 25, 2019.

3. American Heart Association. Part 11: pediatric basic life support and cardiopulmonary resuscitation quality. https://eccguidelines.heart.org/
   index.php/circulation/cpr-ecc-guidelines-2/part-11-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality. Updated 2017. Accessed December 20, 2018

NOTES

Content in the STANDARD was modified on 05/17/2019.